Comparison of curettage with and without high intensity focused ultrasound in the management of caesarean scar pregnancy

To retrospectively evaluate the safety and efficacy of uterine curettage (UC) with and without high intensity focused ultrasound (HIFU) in the management of caesarean scar pregnancy (CSP). We retrospectively analyzed 123 patients with CSP treated between 2022-2023. Patients were divided into two groups: the HIFU combined with UC group (n=54) and the UC alone group (n=69). Medical records were reviewed for clinical outcomes including surgical parameters, recovery indicators, complications, and patient satisfaction. Economic factors including hospitalization duration and treatment costs were also analyzed. Compared with the UC alone group, the HIFU combined with UC group demonstrated significantly reduced surgical time, intraoperative blood loss, bleeding rate during UC, time for β-hCG to return to normal levels, positive blood loss, positive bleeding time, and rate of retained pregnancy tissue (P<0.05). Psychological evaluation showed improved SCL-90, SAS, and SDS scores in the HIFU combined with UC group (P<0.05). While the HIFU combined with UC group had longer hospital stays and higher inpatient costs (P<0.05), there was no significant difference in total treatment costs between groups. Though the HIFU combined with UC group showed trends toward faster menstrual recovery, lower rates of menstrual disorders, fewer uterine perforations, and reduced puerperal morbidity, these differences did not reach statistical significance (P>0.05). This retrospective analysis suggests that combining HIFU with UC provides superior clinical outcomes, fewer complications, faster recovery, and higher patient satisfaction in the treatment of CSP compared to UC alone.